Passenger lymphocyte thrombocytopenia due to human platelet antigen 3a antibodies: Case report and review of literature

Transfusion. 2020 Oct;60(10):2185-2188. doi: 10.1111/trf.15905. Epub 2020 Jun 11.

Abstract

We report a case of severe acute thrombocytopenia occurring within days after a cadaveric liver transplant, received from a female patient with aplastic anemia who died of intracranial bleeding. The donor, who was homozygous for the ITGA2B*002 (HPA-3b) gene, had developed human platelet antigen (HPA)-3a antibodies, whereas the recipient was homozygous for the ITGA2B*001 (HPA-3a) gene. Thrombocytopenia responded to an infusion of immunoglobulin G. This is the first report of a passenger lymphocyte syndrome manifesting with thrombocytopenia due to anti-HPA-3a. We review the literature on thrombocytopenia in the setting of PLS and discuss the differential diagnosis.

Keywords: HPA-3a antibodies; liver transplantation; passenger lymphocyte; thrombocytopenia.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antigens, Human Platelet / immunology*
  • Female
  • Humans
  • Immunoglobulin G / administration & dosage*
  • Isoantibodies / immunology*
  • Liver Transplantation*
  • Male
  • Thrombocytopenia / drug therapy*
  • Thrombocytopenia / etiology
  • Thrombocytopenia / immunology

Substances

  • 3a alloantigen, human
  • 3b alloantigen, human
  • Antigens, Human Platelet
  • Immunoglobulin G
  • Isoantibodies